JPH11332873A - Ultrasonic treatment apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To secure good visibility at all times by forming a suction route continuing to an external suction source at the tip of a probe and enabling free mist generated at the time when a ultrasonic oscillation means to be observed, in a device where the biological tissue is treated by ultrasonic vibration transmitted through the probe. SOLUTION: The ultrasonic treatment apparatus adds a driving signal to a ultrasonic vibrator 12 in a handpiece 4 via an amplifier from a power circuit in the apparatus body 2, and ultrasonic vibration produced in the ultrasonic vibrator 12 is transmitted to a treatment section 13 through a probe 14. In this case, a suction tube connection portion 18 is provided at the base of a slender sheath 15 covering the probe 14. A suction tube 19 as a relay tube is connected to the connection portion 18, and the suction tube 19 is connected to a suction means outside through a pinch valve 10. The visibility of an affected region can be secured by sucking free mist generated at the time of ultrasonic treatment in the treatment section 13 and removing through the suction tube 19.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment apparatus for transmitting ultrasonic vibration through a probe and treating a living tissue with the ultrasonic vibration.

[0002]

2. Description of the Related Art Japanese Patent No. 2544480 discloses a method of cauterizing a part of the abdominal cavity insufflated by an insufflation device using an ablation device such as a high-frequency ablation device or a laser device under observation with an endoscope. A device incorporating a smoke removal system for removing smoke generated during cauterization has been proposed. In this smoke removing system, the cauterizing device, the insufflation device, and the smoke removing suction device are operated in cooperation with each other by the control means.

[0003]

[Problems to be Solved by the Invention]
In the smoke removal system proposed in Japanese Patent No. 2544880, in order to remove smoke generated by an ablation device such as a high-frequency ablation device or a laser device, an operation of a cauterization device, an insufflation device, and an aspiration device is performed. Although they are linked, it is necessary to use signal lines connecting each device for input and output of each device. Therefore, a dedicated interface is required for each device. Furthermore, since the specifications of the output signal lines are not clear, it is necessary to prepare all dedicated devices, and there is a disadvantage that the operator does not have a choice. On the other hand, there is known an ultrasonic treatment apparatus which transmits ultrasonic vibration through a probe and treats a living tissue with the ultrasonic vibration (see Japanese Patent Publication No. 8-505801). In this ultrasonic treatment apparatus, smoke is not generated even when a probe that vibrates ultrasonically for treating a living tissue is brought into contact with the living tissue. However, in the case of a treatment using this ultrasonic treatment device, water around the operating part contacted by the probe may be scattered or floated in a mist state due to a phenomenon called cavitation. Since the mist generated in this way has a larger mass than the smoke particles, it disappears in a short time, but may drift in the abdominal cavity, which deteriorates the visibility of the operative site to a considerable extent. In particular, the surgeon who is concerned about the field of view needs to exchange gas in the abdominal cavity by using a trocar opening valve or the like to temporarily release the insufflation gas to the outside of the abdominal cavity. Was troublesome.

(Purpose) The present invention has been made by paying attention to the above circumstances, and its purpose is to appropriately remove mist generated by ultrasonic vibration without bothering the surgeon, and always improving the mist. It is an object of the present invention to provide an ultrasonic treatment apparatus capable of performing treatment while ensuring a proper view.

[0005]

(Means and Actions for Solving the Problems) (Means) The present invention provides an elongated probe for transmitting ultrasonic vibrations to a living tissue, an ultrasonic vibration generating section for generating the ultrasonic vibrations, and an ultrasonic vibration generating section. In an ultrasonic treatment apparatus having a handpiece having a generator and an ultrasonic oscillator for generating electric energy for ultrasonic vibration to be applied to the ultrasonic vibration generator, external suction is performed from the distal end of the probe or near the distal end. Communication means having a suction path communicating with the source, and suction control means for controlling suction through the suction path of the communication means, wherein the suction control means interlocks with the operation of the ultrasonic oscillation means. The suction path is opened, and the generated floating mist is suctioned and removed through the communication means for suction. (Effect) Even if mist which obstructs the field of view is generated by the ultrasonic treatment, the mist is appropriately removed and a good field of view is secured for the operator during the operation.

[0006]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS [First Embodiment] A first embodiment of the present invention will be described with reference to FIGS. (Configuration) FIG. 1 shows a schematic configuration of the entire ultrasonic treatment apparatus 1. The ultrasonic treatment apparatus 1 includes an apparatus main body 2, a foot switch (or a hand switch) 3 connected to the apparatus main body 2, and a handpiece 4 of an ultrasonic treatment tool. The handpiece 4 is detachably connected to the apparatus main body 2.

A power switch 6 and a display panel 7 are provided on a front panel 5 of the apparatus main body 2. As shown in FIG. 2, the apparatus main body 2 includes a power supply circuit 8 for generating a drive signal to be applied to an ultrasonic transducer described later, a current amplifier 9 for applying power to the drive signal, and a pinch valve 1.
0 and a control circuit 11 are provided. The power supply circuit 8 has ultrasonic oscillation means for generating electric energy for applying ultrasonic vibration.

As shown in FIG. 3, the handpiece 4 includes an ultrasonic vibrator 12 for generating ultrasonic vibration, a probe 14 for transmitting ultrasonic vibration from the ultrasonic vibrator 12 to a treatment section 13, An elongate sheath 15 covering the ultrasonic transducer 12, a hand-side operation unit 17 screwed to a case 16 surrounding the ultrasonic vibrator 12, and a proximal end of the sheath 15. Suction tube connection 18
And

A suction tube 19 serving as a relay tube is connected to the suction tube connecting portion 18, and this suction tube 19 is connected to an external suction means such as a wall suction facility (not shown) through the pinch valve 10 part. . The pinch valve 10 constitutes a valve mechanism that seals or opens the lumen of the suction tube 19 by sandwiching or releasing a middle part of the suction tube 19 to open and close a path of a suction communication unit described later. .

The suction tube 19 communicates with the inside of the sheath 15 through the suction tube connecting portion 18. Then, a suction path extending from the suction tube 19 to the sheath 15 is formed, and this suction path constitutes a suction communication means for connecting an external suction means (suction source) to the distal end opening (suction port) of the sheath 15. Here, the suction path of the suction communication means is divided into a handpiece-side suction path 20 a in the sheath 15 and a relay tube-side suction path 20 b of the suction tube 19, and both are communicated through the suction tube connecting portion 18. . The pinch valve 10 selectively sandwiches a middle portion of the relay tube side suction path 20b, and
Ob is opened and closed to control the suction through the suction path of the communication means for suction.

The operation of the pinch valve 10 is controlled in synchronization with the ultrasonic output of the apparatus main body 2 as shown in FIG. 4. When the ultrasonic output is off, the pinch valve 10 is closed, and when the ultrasonic output is on, the pinch valve 10 is turned on. 10 opens. That is, the suction path is opened in conjunction with the operation of the ultrasonic oscillation means.

(Operation) In the above configuration, by driving the ultrasonic vibrator 12 in the handpiece 4, the ultrasonic vibration is transmitted to the treatment section 13 via the probe 14, and the treatment section 13 is applied to the living tissue. Thus, an ultrasonic treatment can be performed.

In the case of performing lymph node dissection using the ultrasonic treatment apparatus 1, for example, the sheath 15 of the handpiece 4 is introduced into the insufflated abdominal cavity through a trocar (not shown), and the endoscope is used. Under the observation, an ultrasonic treatment is applied to a site to be treated by the probe 14.

Here, as shown in FIG. 4, the operation of the pinch valve 10 is synchronized with the ultrasonic output of the apparatus main body 2, and when the ultrasonic wave is output, the suction path of the suction communication means is opened, so that the ultrasonic treatment is performed. The mist generated and floating can be removed by suction from the opening at the distal end of the sheath 15 to the outside of the body via the suction path of the suction communication means.

(Effect) With the above configuration, the mist generated by the output of the ultrasonic wave at the time of outputting the ultrasonic wave can be removed by suction to the outside of the body, and a good visual field can be secured for the operator.

[Second Embodiment] A second embodiment of the present invention will be described with reference to FIG. However, the same components as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof will be omitted.

(Structure) The communication means for suction in this embodiment is such that the suction path in the handpiece 4 is changed by the ultrasonic vibrator 1
The probe 14 and the probe 14 are formed in the inside thereof, and are formed linearly by a penetrating path 21 communicating with the probe 14 and the ultrasonic transducer 12.
The suction port is formed by the tip opening of the probe 14.

At the rear end of the case 16 containing the ultrasonic vibrator 12, there is provided a suction tube connecting portion 18 communicating with the through passage 21.
Is provided. A suction tube 19 as a relay tube is connected to the suction tube connecting portion 18.

The through passage 21 and the suction tube connecting portion 18 are provided coaxially along the central axis of the handpiece 4, and the suction tube 19 is coaxially connected thereto. Further, the ultrasonic transducer 12, the probe 14, and the suction tube connecting portion 18 are coaxially arranged to constitute an integral unit, and are attached to the case 16 so as to be rotatable around an axis. The portion of the ultrasonic transducer 12 and the suction tube connecting portion 18 is slidably held on the case 16 via an O-ring 22.

(Operation) In this embodiment, the path of the suction communication means is formed inside the ultrasonic transducer 12 to the probe 14 and is formed by the ultrasonic treatment from the opening at the tip of the probe 14 and is floating. Aspirate.

(Effect) Since the mist floating in the body cavity is sucked from the distal end opening of the probe 14 located forward of the distal end of the sheath 15, especially the mist floating in the front visual field is positively sucked. And a good visual field can be secured. Further, since the suction tube 19 is drawn out to the rear of the handpiece 4, the suction tube 19 does not become entangled with the sheath 15 even if the handpiece 4 is rotated during the operation. Further, since the suction tube connecting portion 18 is attached to the case 16 so as to be rotatable around the axis, the suction tube 19 is not twisted even if the handpiece 4 is rotated during the operation.

[Third Embodiment] A third embodiment of the present invention will be described with reference to FIGS. However, the same components as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.

(Configuration) In the third embodiment, a suction control device 33 provided with an external input terminal 31, a suction control unit 32, and a pinch valve 10 is provided separately from the device main body 2, and Reference numeral 2 denotes an external signal terminal 34 and switching means 3 for switching the state of signal output to the external signal terminal 34.
5 is provided.

(Operation) In the above configuration, the apparatus main body 2
Operates the switching means 35 in synchronization with the ultrasonic output based on a command from the control circuit 11, and is controlled as shown in FIG. In other words, while the ultrasonic output is being performed, a signal indicating that the ultrasonic output is being performed can be taken out from the external signal terminal 34, and this signal is transmitted from the external input terminal 31 of the suction control device 33 to the suction control. Take it into the unit 32. Then, at a timing synchronized with the ultrasonic output of the device main body 2,
By opening the pinch valve 10 in the suction control device 33, the mist is removed by suction as described above.

By using this signal, the operation of a device that does not aim at suction control, such as applying a bipolar output by a high-frequency ablation device to improve the hemostasis effect, may be linked with the ultrasonic output. Further, a plurality of devices may be controlled.

(Effect) With the above configuration, it is possible to synchronize the operation of a plurality of devices with the ultrasonic output using an external signal terminal, not limited to the suction of the mist.

[Fourth Embodiment] A fourth embodiment of the present invention will be described with reference to FIGS. However, the first
The same components as those of the first to third embodiments are denoted by the same reference numerals, and detailed description thereof will be omitted.

(Structure) FIG. 8 shows a handpiece 40 of an ultrasonic coagulation and incision apparatus among ultrasonic treatment apparatuses. The handpiece 40 is provided with a support member 41 penetrating the vicinity of the distal end of the probe 14 in the distal end of the sheath 15, and a gripping member (jaw) 42 facing the distal end of the probe 14 is rotatably pivoted on the support member 41. Is being worn. The support member 41 is provided with a suction hole (through path) 43 penetrating along the axial direction of the sheath 15. A relay tube 44 inserted into the sheath 15 is connected to the suction hole 43. The relay tube 44 is connected so as to communicate with the suction tube connecting portion 18 provided at the rear end of the hand-side operation portion 17. Further, a suction tube 19 as a relay tube is connected to the suction tube connecting portion 18. Then, the suction hole 43, the relay tube 44, and the suction tube 1
A suction path communicating over 9 is formed to constitute suction communication means.

The opening at the tip end of the suction hole 43 is opened and closed by a sealing lid member 45 interlocked with the rotation of the gripping member 42. The sealing lid member 45 is held by an elastic member 46 attached to the back surface of the gripping member 42, and is capable of elastically swinging to some extent. Then, as shown in FIG. 8, only when the gripping member 42 is in a gripping state in which the gripping member 42 falls in a direction in which the gripping member 42 contacts the distal end of the probe 14, the sealing lid member 45 holds the suction hole 4.
3 is opened. Further, as shown in FIG. 9, the closed lid member 45 is in the grip release state in which the grip member 42 is raised.
Closes the tip opening of the suction hole 43.

A fixed handle 51 and a movable handle 52 are provided on the operation unit 17 on the hand side of the handpiece 40. By rotating the movable handle 52 with respect to the fixed handle 51, the gripping member 42 becomes a support member 41.
, And comes into contact with and separates from the tip of the probe 14. That is, as the movable handle 52 is closed, the gripping member 42 pivots in a direction to close toward the distal end of the probe 14, and as shown in FIG.
A living tissue such as a blood vessel in a human body can be gripped between the probe and the tip of the probe 14.

(Operation) In the above configuration, by driving the ultrasonic vibrator 12 in the handpiece 40, the distal end of the probe 14 and the
The living tissue is grasped in between, and ultrasonic vibration is applied to the probe 14, whereby the grasped living tissue can be coagulated and incised.

Here, when coagulating and incising the living tissue, the living tissue is gripped until the coagulating and incision is completed, and as shown in FIG. 10, the gripping member 42 and the distal end of the probe 14 are closed. Accordingly, the distal end opening of the suction hole 43 is opened, and the state is opened to the maximum just before the coagulation incision is completed. Therefore, when the living tissue is grasped, the suction operation through the suction hole 43 is started, and the mist floating in the body cavity is suctioned and removed outside the body through the suction path of the suction communication means.

(Effect) The tip end opening of the suction hole 43 of the suction communication means is opened and closed in conjunction with the movement of the gripping member 42. Therefore, means for separately controlling the suction such as a pinch valve outside the handpiece 40 is provided. It is unnecessary, has a simple structure, is low in cost, and can realize suction removal of mist.

[Fifth Embodiment] A fifth embodiment of the present invention will be described with reference to FIG. However, the same components as those of the first to fourth embodiments are denoted by the same reference numerals, and detailed description thereof is omitted.

(Structure) In the fifth embodiment, the suction control device 6 is provided separately from the device main body 2 of the ultrasonic treatment device 1.
A sound collecting means 61 for detecting the ambient sound at 0;
A detection circuit 62 for separating and detecting the sound generated in the ultrasonic frequency band generated when the probe 14 is ultrasonically vibrated by the ultrasonic output from the surrounding sound, a control circuit 63, and the pinch valve 10. .

(Operation) In the above configuration, the sound collecting means 6
The ambient sound measured by 1 is judged by the detection circuit 62 as to whether or not there is a frequency component in the ultrasonic frequency band, and when it is detected, the ultrasonic output is regarded as being performed, and the pinch valve 10 is turned on. The mist generated by opening can be removed by suction.

In order to further improve the detection accuracy and usability, a threshold value is set for the opening timing so that the pinch valve 10 is opened for the first time when a frequency component in a continuous ultrasonic frequency band for a predetermined time or more is detected. May be.

(Effect) With the above configuration, the mist generated by the ultrasonic output can be suctioned out of the body regardless of the type of the ultrasonic treatment apparatus 1.

<Supplementary Notes> An elongated probe for transmitting ultrasonic vibrations to a living tissue, an ultrasonic vibration generating section for generating the ultrasonic vibration, a handpiece having the ultrasonic vibration generating section, and an ultrasonic wave applied to the ultrasonic vibration generating section An ultrasonic treatment device having an ultrasonic oscillation means for generating electric energy for vibration, a communication means having a suction path communicating from a tip or near the tip of the probe to an external suction source, and suction of the communication means. Suction control means for controlling suction through the path, interlocking with the operation of the ultrasonic oscillation means, opening the suction path by the suction control means, and removing the floating mist generated through the communication means for suction. An ultrasonic treatment apparatus characterized by being removed by suction. 2. A probe that transmits ultrasonic vibrations to tissue, and a handpiece having a vibration generating unit for generating ultrasonic vibrations,
In an ultrasonic treatment apparatus having ultrasonic oscillation means for generating electric energy for applying ultrasonic vibration to the vibration generating section of the handpiece, a suction port for sucking mist to the handpiece, and a suction port A suction path communicating with a more external suction means and a suction control means for controlling the state of the suction path are provided, the suction control means is operated in synchronization with the operation of the ultrasonic oscillation means, and the suction path is opened, An ultrasonic treatment device characterized by removing mist by suction.

3. 3. The ultrasonic treatment apparatus according to claim 1, wherein the suction control means is provided in a suction path of the handpiece. 4. 3. The ultrasonic treatment apparatus according to claim 1, wherein the suction control means is provided in a suction port of the handpiece. 5. 3. The ultrasonic treatment apparatus according to claim 1, wherein the suction control unit operates in synchronization with ON / OFF of an ultrasonic output. 6. The suction control means operates by detecting a frequency generated by an ultrasonic output.
Item 3. The ultrasonic treatment apparatus according to Item 2.

[0041]

As described above, according to the present invention, the mist generated by the ultrasonic vibration can be appropriately removed without bothering the operator, and the operator can always perform treatment while maintaining a good view for the operator. It is possible to provide a simple ultrasonic treatment device.

[Brief description of the drawings]

FIG. 1 is an explanatory view schematically showing an entire ultrasonic treatment apparatus according to a first embodiment.

FIG. 2 is an electric circuit diagram of the ultrasonic treatment apparatus.

FIG. 3 is a longitudinal sectional view of the vicinity of a handpiece of the ultrasonic treatment apparatus.

FIG. 4 is an operation characteristic diagram of the ultrasonic treatment apparatus.

FIG. 5 is a longitudinal sectional view of the vicinity of a handpiece of an ultrasonic treatment apparatus according to a second embodiment.

FIG. 6 is an electric circuit diagram of an ultrasonic treatment apparatus according to a third embodiment.

FIG. 7 is an operation characteristic diagram of the ultrasonic treatment apparatus.

FIG. 8 is an explanatory diagram around a handpiece of an ultrasonic treatment apparatus according to a fourth embodiment.

FIG. 9 is an explanatory diagram of a use state of the handpiece of the ultrasonic treatment apparatus.

FIG. 10 is a longitudinal sectional view of a treatment portion of a handpiece of the ultrasonic treatment apparatus.

FIG. 11 is an explanatory view schematically showing an entire ultrasonic treatment apparatus according to a fifth embodiment.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Ultrasonic treatment apparatus, 2 ... Device main body, 4 ... Handpiece, 8 ... Power supply circuit, 9 ... Current amplifier, 10 ... Pinch valve, 11 ... Control circuit, 12 ... Ultrasonic vibrator, 13 ... Treatment part, 14 ... probe, 15 ... sheath, 17 ... hand side operation part, 18 ... suction tube connection part, 19 ... suction tube,
20a, 20b ... suction path.

Claims (1)

[Claims] An elongated probe for transmitting ultrasonic vibrations to a living tissue; an ultrasonic vibration generator for generating the ultrasonic vibration; a handpiece having the ultrasonic vibration generator; In an ultrasonic treatment apparatus having an ultrasonic oscillation means for generating electric energy for ultrasonic vibration to be applied to the portion, a communication means forming a suction path communicating from a tip or near the tip of the probe to an external suction source, Suction control means for controlling suction through the suction path of the communication means, in conjunction with the operation of the ultrasonic oscillation means, to open the suction path by the suction control means, through the communication means for suction, An ultrasonic treatment apparatus wherein generated floating mist is removed by suction.